Pulmonologiya最新文献

{"title":"Challenge No.3 Differential diagnosis of cystic lung masses","authors":"O. Brodskaya, D. Soldatov, M. A. Makarova, N. Bukhtoyarova","doi":"10.18093/0869-0189-2023-33-1-129-131-134-136","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-1-129-131-134-136","url":null,"abstract":"<jats:p>.</jats:p>","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90287912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the pathogenesis of destructive pneumonia during COVID-19: a clinical case","authors":"O. Zaytseva, E. Tolstova, D. Khaspekov, N. V. Tkachenko, N. A. Scholohova, H. Simonovskaya, Т. Y. Belyaeva","doi":"10.18093/0869-0189-2023-33-1-92-101","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-1-92-101","url":null,"abstract":"Community-acquired pneumonia is a potentially serious infection in children with high morbidity rate, risk of severe course and unfavorable outcomes. Specialists have noted the increased incidence of the destructive forms in the recent years.Aim. To present a clinical case of destructive pneumonia in a 1 year 2 month old child, hospitalized in the State Budgetary Healthcare Institution “Children’s City Clinical Hospital of St. Vladimir Moscow Healthcare Department”, and analyze it in terms of current understanding on the disease pathogenesis.Conclusion. During COVID-19 (COronaVIrus Disease 2019) pandemic, pulmonologists and pediatric surgeons encountered an unconventional course of destructive pneumonia. A large number of studies of pathophysiological processes in acute viral interstitial pneumonias have recently allowed to expand our understanding of the role of coagulation system. At the same time, new questions arose concerning the clinical course and development of the pathological infectious process.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77217106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of human ribosomal gene complex in cystic fibrosis","authors":"E. Kondratyeva, E. Ershova, E. Nikolaeva, N. N. Veyko, V. Sherman, Y. Mel’yanovskaya, S. Krasovskiy, S. Kostyuk","doi":"10.18093/0869-0189-2023-33-1-7-16","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-1-7-16","url":null,"abstract":"Increasing the life expectancy of patients with CF is an urgent healthcare task all over the world. According to the Register of patients with cystic fibrosis in the Russian Federation (2020), the number of patients over 18 years of age is 26.5%. Assumably, cystic fibrosis can be used as a model of accelerated aging to study the aging process in general.Aim of the study was to analyze the number of rDNA copies in a sample of cystic fibrosis patients at different ages and with lethal outcome in relation to lung function, complications, and respiratory tract infections.Methods. We studied DNA samples isolated by the standard method from peripheral blood leukocytes of 277 patients diagnosed with cystic fibrosis. 998 DNA samples from healthy volunteers were used as a control group.Results. The study showed that the genomes of patients with CF contain more rDNA copies than those of control patients. The greatest number of copies of ribosomal genes was observed in DNA samples from deceased patients (p < 0.001) and was associated with more severe disease course. Among all CF patients, the largest number of rDNA copies in the genome was registered in patients with the lowest FEV1 values (less than 40%). It was found that patients with chronic Burkholderia cepacia complex infection had a significantly higher number of copies of ribosomal repeats than the total sample (p = 0.001) and the adults (p = 0.014). The number of ribosomal repeats did not differ between patients with other chronic respiratory tract infections.Conclusion. In the group of deceased patients, the patients with low respiratory function and Burkholderia cepacia complex infection had the highest number of rDNA copies in the genome, and the differences were significant. It can be assumed that the number of rDNA copies in the genome of CF patients is an additional prognostic marker that is associated with the patient’s life expectancy.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76084446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of mast cells and their proteases in lung damage associated with COVID-19","authors":"A. Budnevsky, S. Avdeev, E. S. Ovsyannikov, V. V. Shishkina, D. Esaulenko, A. Filin, I. Savushkina, Inna M. Perveeva, N. Alekseeva","doi":"10.18093/0869-0189-2023-33-1-17-26","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-1-17-26","url":null,"abstract":"The new coronavirus infection COVID-19 (Coronavirus Disease 2019) caused by SARS-CoV-2, has posed scientific and public health challenges. The problem of treating COVID-19 still remains, and the pathogenesis of COVID-19 needs to be studied in detail, including the involvement of mast cells (MCs) and their specific proteases.The aim of this study was to characterize the role of mast cell proteases chymase, tryptase, and carboxypeptidase A3 (CPA3) in the lung damage associated with COVID-19.Methods. The study included postmortem lung biopsies from 30 patients who died of severe COVID-19, and biopsies from 9 control group patients. Histological preparations were made and protease profile and degranulation activity of MCs were analyzed. In addition, some demographic, clinical, and laboratory parameters were analyzed.Results. The average number of tryptase-positive MCs without evidence of degranulation and the total number of CPA3-positive MCs were statistically significantly higher in patients with COVID-19, and the number of tryptase-positive and CPA3-positive MCs fragments was lower compared with controls. Negative correlations were established between the numbers of tryptase-positive MCs and red blood cell count. Negative correlations were found between non-granulating tryptase-positive MCs and hemoglobin levels. Positive correlations were noted between tryptase-positive MCs and the leukocytes and eosinophils counts, and negative correlations were noted between the number of CPA3-positive cells and the platelet count. A positive correlation was found between the number of adjoining MCs, as well as fragments of tryptase-positive MCs, and the erythrocyte sedimentation rate (ESR). A negative correlation was also observed between the number of non-degranulated CPA3-positive MCs and the blood level of C-reactive protein. In patients with COVID-19, reduced degranulation activity of tryptase-positive MCs was found along with increased representation of CPA3positive MCs. Several trends and associations with laboratory test results were noted. The potential involvement of MCs in the development of anemia and thrombocytopenia is considered. Associations were established between tryptase-positive MCs and the peripheral blood counts of leukocytes and eosinophils, as well as ESR.Conclusion. The results obtained are highly contradictory. Since many aspects of the involvement of MCs and their proteases in COVID-19 pathogenesis are still unknown, studies with larger cohorts of patients are needed.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"66 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83838369","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment, diagnostics, and management of chronic obstructive pulmonary disease in women","authors":"F. Malykhin, V. Baturin","doi":"10.18093/0869-0189-2023-33-1-76-83","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-1-76-83","url":null,"abstract":"Chronic obstructive pulmonary disease (COPD) poses a significant burden on women’s health. Insufficient attention is paid to this problem in scientific research and in clinical practice, although more and more information surfaces about the gender-associated differences in the treatment, diagnostics, and management of COPD.The aim of the review is to consider the most significant data currently available on the clinical signs, course, and outcomes of COPD in women and propose ways to achieve the best results in the diagnosis and treatment of this disease.Conclusion. There are biological and cultural differences between the clinical manifestations, course and outcome of COPD in men and women, and these differences impact the clinical practice. It is advisable to apply individualized diagnostic, organizational, and pharmacotherapeutic approaches to COPD in women, based on the knowledge of female-specific variances in the symptoms of the disease and the health status.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"26 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82233354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bronchodilator therapy in patients with chronic obstructive pulmonary disease: what should be considered in clinical practice when choosing a dosing regimen?","authors":"O. Titova, N. Kuzubova, A. Kozyrev, A. A. Shumilov","doi":"10.18093/0869-0189-2023-33-1-44-50","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-1-44-50","url":null,"abstract":"The use of long-acting bronchodilators is central to the chronic obstructive pulmonary disease (COPD) therapy. One of the goals of bronchodilation is to reduce the morning COPD symptoms that are associated with a more severe disease and an increased risk of exacerbations.The aim of the study was to evaluate the clinical efficacy of switching COPD patients with severe morning symptoms who received combinations of long-acting bronchodilators QD to a fixed-dose combination of aclidinium bromide (AB) and formoterol fumarate (FF) BID.Methods. We examined COPD patients treated with combinations of long-acting β2-agonists and M-anticholinergics (but not AB and FF), who continued to complain of severe symptoms in the morning despite the treatment. After examination, the patients were switched to the fixed-dose combination of AB 0.4 mg and FF 0.012 mg (AB/FF) BID in the form of a metered-dose powder inhaler. The patients were examined at baseline and at 6-month follow-up.Results. Of the 115 included COPD patients, 90 completed the study. After 6 months of treatment, they showed a significant decrease in the intensity of cough, sputum amount, severity of distant wheezing, and shortness of breath in the morning (–0.88, –0.38, –0.29, –0.58 on a 4-point scale, the mean score –0.44; p < 0.001). The result of the COPD Assessment test decreased from 28 (24; 34) to 24 (20; 28) (p = 0.011), the distance of a 6-minute walk increased from 319 ± 72 to 354 ± 67 m (p < 0.001). The fixed-dose combination of AB/FF did not cause serious adverse events.Conclusion. The fixed-dose AB/FF combination in COPD patients resulted in a significant clinical improvement and was well tolerated. The AB/FF combination with twice daily dosing regimen is advisable for the patients with morning symptoms persisting despite therapy with other combinations of long-acting bronchodilators with once daily dosing regimen.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"94 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91023847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The inspiratory activity of respiratory center and respiratory muscles strength after COVID-19","authors":"O. Savushkina, A. A. Zaicev, E. Kryukov, P. Astanin, N. A. Aseeva, M. Malashenko, O. Fesenko","doi":"10.18093/0869-0189-2023-33-1-27-35","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-1-27-35","url":null,"abstract":"The respiratory pump that provides pulmonary ventilation includes the respiratory center, peripheral nervous system, chest and respiratory muscles.The aim of this study was to evaluate the activity of the respiratory center and the respiratory muscles strength after COVID-19 (COronaVIrus Disease 2019).Methods. The observational retrospective cross-sectional study included 74 post-COVID-19 patients (56 (76%) men, median age – 48 years). Spirometry, body plethysmography, measurement of lung diffusing capacity (DLCO), maximal inspiratory and expiratory pressures (MIP and MEP), and airway occlusion pressure after 0.1 sec (P0.1) were performed. In addition, dyspnea was assessed in 31 patients using the mMRC scale and muscle strength was assessed in 27 of those patients using MRC Weakness scale.Results. The median time from the COVID-19 onset to pulmonary function tests (PFTs) was 120 days. The total sample was divided into 2 subgroups: 1 – P0.1 ≤ 0.15 kPa (norm), 2 – > 0.15 kPa. The lung volumes, airway resistance, MIP, and MEP were within normal values in most patients, whereas DLCO was reduced in 59% of cases in both the total sample and the subgroups. Mild dyspnea and a slight decrease in muscle strength were also detected. Statistically significant differences between the subgroups were found in the lung volumes (lower) and airway resistance (higher) in subgroup 2. Correlation analysis revealed moderate negative correlations between P0.1 and ventilation parameters.Conclusion. Measurement of P0.1 is a simple and non-invasive method for assessing pulmonary function. In our study, an increase in P0.1 was detected in 45% of post-COVID-19 cases, possibly due to impaired pulmonary mechanics despite the preserved pulmonary ventilation as well as normal MIP and MEP values.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83192604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of bovhyaluronidase azoximer (Longidase) in patients with post-COVID syndrome: results of an open, prospective, controlled, comparative, multicenter clinical trial DISSOLVE","authors":"A. Chuchalin, P. Yablonskiy, T. V. Rubanik, O. A. Chernyavskaya, V. Naumov, L. I. Korneva, L. M. Kudelуa, A. Petukhova, O. Masalkina, Yu. V. Argamakova, G. Ignatova, A. Borisov, T. Kasyanova, A. Suleymanova","doi":"10.18093/0869-0189-2023-33-1-52-63","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-1-52-63","url":null,"abstract":"Post-COVID syndrome develops after COVID-19 (COronaVIrus Disease 2019) and leads to cumulative effects in the form of shortness of breath and impaired lung function. Notably, patients with airway inflammation and COVID-19 were found to have increased concentrations of hyaluronic acid (HA). Since bovhyaluronidase azoximer (Longidase®) catalyzes the hydrolysis of HA, this drug has the potential to reduce HA levels and improve lung function in patients with post-COVID syndrome.The aim of the DISSOLVE trial, which was conducted early in the pandemic, was to investigate the efficacy and safety of bovhyaluronidase azoximer in patients with symptoms associated with post-COVID syndrome.Methods. An open, prospective, controlled, comparative, multicenter clinical trial (NCT04645368) included adult patients (n = 160) who had post-COVID syndrome. Patients in the treatment group (n = 81) received bovhyaluronidase azoximer, and individuals in the control group (n = 79) were followed up without intervention. The study included physical examination, evaluation of forced vital capacity (FVC), assessment of dyspnea with the Modified Medical Research Council Dyspnea Scale (mMRC), 6-minute walking test, and pulse oximetry. These indicators were measured on 3 visits, at days 1 (baseline), 75, and 180. In addition, the number of patients who experienced adverse events and serious adverse events were recorded.Results. Baseline patient characteristics in the treatment group and the control group were similar. In the treatment group, there was a statistically significant reduction in residual pulmonary abnormalities after visit 2 (day 75) and visit 3 (day 180). In addition, FVC, pulse oximetry values, and functional exercise tolerance increased statistically significantly at days 75 and 180 compared to baseline. The mMRC scores for dyspnea decreased statistically significantly in the treatment group over 75 days. The safety profile of the drug was reported to be favorable throughout the study. Conclusion. Treatment with bovhyaluronidase azoximer in patients with post-COVID syndrome showed improvement in FVC, pulse oximetry, functional exercise tolerance, and mMRC dyspnea.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82658341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in mortality rates and hospital mortality associated with bronchial asthma in the population of the Russian Federation (2014 – 2018)","authors":"Е.В.Быстрицкая, Т.Н.Биличенко, E. Bystritskaya, T. Bilichenko","doi":"10.18093/0869-0189-2023-33-4-454-460","DOIUrl":"https://doi.org/10.18093/0869-0189-2023-33-4-454-460","url":null,"abstract":"Bronchial asthma (BA) is one of the leading chronic non-communicable diseases in all age groups and has been noted by WHO and GINA due to the large socio-economic burden on society. Aim. The analysis of mortality rates (MR) and hospital mortality (HM) due to BA in the Russian population in 2014 and 2018. Methods. The statistical information of the Ministry of Healthcare of the Russian Federation and Federal State Statistics Service of the Ministry of Economic Development of the Russian Federation on the MR and HM associated with BA was used. Results. The mortality rate (MR) associated with BA in Russia was 1.2 per 100 thousand population in 2014 and 0.9 in 2018, which corresponded to 2% of mortality from all respiratory diseases. The maximum MR was registered in the Volga Federal District (in 2014 – 1.7, in 2018 – 1.1 per 100 thousand population). Among the working age population, the average MR due to BA was registered at the level of 0.4 per 100 thousand in 2014 and 0.3 in 2018. Among the population older than working age, MR was 4.2 in 2014. In 2018, MR due to BA decreased by 1.5 times to 2.7 per 100 thousand in the older age group (p = 0,026). MR due to BA in the urban population in 2018 was 2 times higher than in the rural population, and was 1.6 times higher in women than in men. Hospital mortality (HM) in the adult population in 2014 and 2018 stayed at the level of 0.3%. Conclusion. The early diagnosis and follow-up of patients with asthma and control of asthma among different age groups contribute to gradual decrease in MR.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79424831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differential diagnosis of community-acquired pneumonia and lung damage in respiratory viral infections, including COVID-19","authors":"D. Strelkova, A. A. Irgiskin, S. Rachina","doi":"10.18093/0869-0189-2022-4161","DOIUrl":"https://doi.org/10.18093/0869-0189-2022-4161","url":null,"abstract":"With the development of the coronavirus pandemic and its decline, bacterial pathogens will again play a significant role in the epidemiology of community-acquired pneumonia (CAP). Numerous studies have already examined clinical, laboratory, and instrumental indicators that allow differential diagnosis between viral infection and bacterial pneumonia. The role of conventional (e.g., C-reactive protein, procalcitonin, leukocytes) and novel laboratory markers (e.g., MxA1 protein, progranulin, copeptin) was revealed. Differences in lung CT and ultrasound findings were noted. The aim of this publication is to present data on the differential diagnosis between pulmonary involvement in viral infections, including COVID-19 (COronaVIrus Disease 2019), and bacterial CAP. Conclusion. Despite numerous studies, distinguishing bacterial CAP from viral lung injury, including that associated with COVID-19 infection, without microbiologic testing is a challenging task that requires a combined assessment of clinical data, laboratory data, and modern imaging studies. Obviously, express testing will be of particular interest in this case.","PeriodicalId":37383,"journal":{"name":"Pulmonologiya","volume":"92 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78585847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}